--
"Steamboat Ed" Haas : Blue Cross socks us
Hacking the Trailing Edge! : $23,000/yr!! ...
www.nmpproducts.com
---Decks a-wash in a sea of words---
I've had Kaiser for 30 years. I'm 58 years old
and I pay $458/month. The copay is high, but we
fund an HSA account for $1500 a year and that will
cover all the copays for us plus eyeglasses.
Works out to $7000 a year, less than 1/3 what
you're paying.
> --Well now that the balance in congress has been tipped and
>everyone's been safely bought off, sure enough Blue Cross has raised my
>rates: 22% this time; total's now $23,000/yr. I need customers or a new line
>of work! I'd be curious to know if anyone's got group coverage thru AWS or
>any other industry group and what your experience has been with them..
==========
Like the carnival owner said "I mitted the shamus*, so Let'er
rip....." [obscure American slang for bribing local law
enforcement]
Only 22%!
Anthem Blue Cross has told some {est. 800k} customers it will
raise their health insurance premiums as much as 39 percent
beginning March 1.
http://www.sacbee.com/state_wire/story/2516013.html
http://www.sacbee.com/296/story/2522895.html
<snip>
Sebelius said Anthem Blue Cross' parent company, WellPoint Inc.,
"has seen its profits soar, earning $2.7 billion in the last
quarter of 2009 alone."
<snip>
Unka George (George McDuffee)
..............................
The past is a foreign country;
they do things differently there.
L. P. Hartley (1895-1972), British author.
The Go-Between, Prologue (1953).
>Sebelius said Anthem Blue Cross' parent company, WellPoint Inc.,
>"has seen its profits soar, earning $2.7 billion in the last
>quarter of 2009 alone."
What is that number as a percentage of reciepts?
Wes
Don't know if Blue Cross is the same as Blue Cross Blue Shield, but I was
paying
$9,930 for a family of 4 with a $2,500 deductible. Last year I decided to
try something
to reduce costs. I got a high deductible ($10,000) and a Health Savings
Account. My premium
went down to $4,320. I fund the HSA with the money I saved on the reduced
premium ($5,610).
I add a little to make it to the maximum contribution of $5,850 (2009). The
contribution
is tax deductible on federal income taxes.
I opened my HSA in June 2009 and only used about $700 from the account so
after
putting in my 2010 contribution I'll have more than the $10,000 deductible
in the HSA.
At retirement the money can be rolled into an IRA.* I wish I would have
started this
when the plan was first passed by congress.
Mike
* Always check this with your accountant.
Unfortunately, Kaiser isn't in all states, mostly the Western ones.
I've had them going on 30 years myself, started out at $6 every 2
weeks for just myself. They're a nonprofit and have a lot of emphasis
on prevention. No dental and no eyeglass benefits for the current
program, think it's about $60 every two weeks, it's been getting
jacked up, too. Recently got two Stellite hip joints and a bit of
heart work done for $250 for each hospital visit. Figure that's a
bargain, even if I paid about 30 years of premiums before collecting
anything big. But that's what insurance is for. Don't know what's
available in the rest of the country that's similar.
Stan
I know approximately where Steamer lives and Kaiser is there.
Have you heard about the 40% increases?
TMT
Maybe these type of increases will be what it takes to make people
understand that health care reform needs to happen.
Or we can just sit and watch the Republicans keep saying "No" as we
write the checks for the +40% premiums.
I don't see any Republicans offering to pay these 40% increases for
their unemployed sheeple.
TMT
> I don't see any Republicans offering to pay these 40% increases for
> their unemployed sheeple.
>
Why should they?
Those "sheeple" are all Democrats and 0bama believers. <grin>
Ed, they're doing it because they can. As I've said many times, for
individual policies, there is NO real competition in that business. It's a
pure, or nearly pure, oligopoly.
For example, why haven't you just shopped around for another policy at a
better price?
--
Ed Huntress
Well, for us it's one of those risk management issues.
There's ways to work the Kaiser system and find and
see a doctor you like. In any case, health care reform
is going to look a lot more like Kaiser than Blue Cross...
On the other hand, if you need an outside specialist, you'll GET an
outside specialist with Kaiser. The cardiac surgeon I had was one of
the top guys in the area, I got tested, diagnosed and was on the table
in less than three weeks. When I was in CA, one friend was on
continuing kidney dialysis, they didn't have a machine for that
locally so they paid to send her over to USF hospital for it twice a
week and eventually for her kidney transplant. And nothing prevents
you from getting an outside diagnosis for anything they recommend, did
that myself for both the cardiac problems and the hips. We're a
little different around here, Kaiser contracts with local hospitals
for in-patient care, they don't have their own like in CA. The
hospital I was in had a cardiac research unit associated with it, the
surgeon was part of that. The hospital does about 600 heart
procedures a year. Probably not going to be the case with Kaiser-run
facilities. So quality of care is probably still going to vary with
locale. And other docs than Kaiser's make mistakes, too. I'd grade
Kaiser at abour a B around here, grade A being celeb-level care. Good
enough to keep me alive for the last couple of years and let me get
around without joint pain after the repairs.
Stan
That was sort of a leading question, which I didn't intend. The point is,
you rarely find significantly different deals among the major health care
insurers. It's not collusion; it's just that they all have the same
interest, and therefore there is no real competition. It's in their mutual
interest to offer roughly the same products, at approximately the same
price. That's how oligopolies work.
--
Ed Huntress
>On 09 Feb 2010 21:07:27 GMT, steamer <ste...@sonic.net> wrote:
>
>> --Well now that the balance in congress has been tipped and
>>everyone's been safely bought off, sure enough Blue Cross has raised my
>>rates: 22% this time; total's now $23,000/yr. I need customers or a new line
>>of work! I'd be curious to know if anyone's got group coverage thru AWS or
>>any other industry group and what your experience has been with them..
>==========
>Like the carnival owner said "I mitted the shamus*, so Let'er
>rip....." [obscure American slang for bribing local law
>enforcement]
======
In case you missed it.
http://news.yahoo.com/s/ap/20100213/ap_on_he_me/us_insurance_rates_states;_ylt=AvtdhNOFEa0dW2CjL4tjVCjVJRIF;_ylu=X3oDMTJxajB1aDBiBGFzc2V0A2FwLzIwMTAwMjEzL3VzX2luc3VyYW5jZV9yYXRlc19zdGF0ZXMEY3BvcwMxBHBvcwMyBHNlYwN5bl90b3Bfc3RvcnkEc2xrA2luZGl2aWR1YWxpbg--
Individual insurance rates soar in 4 states
By LINDA A. JOHNSON, AP Business Writer Linda A. Johnson, Ap
Business Writer � Fri Feb 12, 8:39 pm ET
TRENTON, N.J. � Consumers in at least four states who buy their
own health insurance are getting hit with premium increases of 15
percent or more � and people in other states could see the same
thing.
Anthem Blue Cross, a subsidiary of WellPoint Inc., has been under
fire for a week from regulators and politicians for notifying
some of its 800,000 individual policyholders in California that
it plans to raise rates by up to 39 percent March 1.
The Anthem Blue Cross plan in Maine is asking for increases of
about 23 percent this year for some individual policyholders.
Last year, they raised rates up to 32 percent.
<snip>
And in Oregon, multiple insurers were granted rate hikes of 15
percent or more this year after increases of around 25 percent
last year for customers who purchase individual health insurance,
rather than getting it through their employer.
<snip>
"You're going to see rate increases of 20, 25, 30 percent" for
individual health policies in the near term, Sandy Praeger,
chairwoman of the health insurance and managed care committee for
the National Association of Insurance Commissioners, predicted
Friday.
Most states don't have the legal authority to block or reduce
health insurance rate increases, Praeger noted.
<snip>
Under Anthem's proposal, a family of four could be charged up to
$1,876 per month if the proposed rates are allowed to take effect
in July.
==============
{editorial comment -- gross US median family income is now about
50k$/year.
http://www.census.gov/hhes/www/income/statemedfaminc.html
1,876/month = c. 22.5k$/year for medical insurance.
How can the typical median family afford to spend c. 45% of their
gross income on health insurance? Also remember that 50% of the
families have *LESS* than 50k$ annual income. -- Unka' George}
They can't. But who cares? If we did something to put a lid on the insurance
companies, that would be socialism. Can't have that.
So hang on. And remember, insurance companies make a *percentage* of their
total take. Lower healthcare costs do almost nothing to improve their bottom
line. In fact, it's just the opposite.
Call it the "Republican premium."
--
Ed Huntress
>> {editorial comment -- gross US median family income is now about
>> 50k$/year.
>> http://www.census.gov/hhes/www/income/statemedfaminc.html
>> 1,876/month = c. 22.5k$/year for medical insurance.
>> How can the typical median family afford to spend c. 45% of their
>> gross income on health insurance? Also remember that 50% of the
>> families have *LESS* than 50k$ annual income. -- Unka' George}
>
>They can't. But who cares? If we did something to put a lid on the insurance
>companies, that would be socialism. Can't have that.
>
>So hang on. And remember, insurance companies make a *percentage* of their
>total take. Lower healthcare costs do almost nothing to improve their bottom
>line. In fact, it's just the opposite.
========
Indeed they cannot.
The problem is that people don't stop getting sick or injured
just because they don't have health insurance.
Its the taxpayers [through governmental social services] and
other medical consumers [who pay their bills] that subsidize
these costs. These costs are greatly amplified and exacerbated
because preventative care [e.g. immunizations and prenatal care]
or early stage intervention was not available, and
heroic/emergency care is then required when a crisis finally
occurs.
It should be obvious that the U.S. already has universal medical
care, including large numbers of undocumented immigrants.
Unfortunately, much of this medical care is marginal and late,
thus combining inefficiency / ineffectiveness with excessively
high [hidden] costs.
Exactly.
>
> It should be obvious that the U.S. already has universal medical
> care, including large numbers of undocumented immigrants.
> Unfortunately, much of this medical care is marginal and late,
> thus combining inefficiency / ineffectiveness with excessively
> high [hidden] costs.
Yes, we do. And, yes, it is. We're paying for universal disaster care. The
idea of health care reform is to change it so we pay for better care --
which costs less, and which could cost a *lot* less if we acknowledged the
fact that market incentives in health care are inherently perverse, and that
we need to manage them. That's how the Europeans manage it for 1/3 less than
we pay.
--
Ed Huntress
>So hang on. And remember, insurance companies make a *percentage* of their
>total take. Lower healthcare costs do almost nothing to improve their bottom
>line. In fact, it's just the opposite.
>
>Call it the "Republican premium."
So are 7 year loans on automobiles that make it possible to pay for an overpriced Obama
motors/UAW/GM car an "Democrat Premium"?
Seriously, at a certain point, you loose sales. An insuance company makes nothing if a
company drops their group coverage. Due to how law is that people showing up at the e
room must be treated and that cost is passed on to those that can pay, perhaps the
insurance company looses money. My belief is while insurance companies like to make
money, they also like to be able to find buyers for their product.
Wes
Nope. They aren't trying to kowtow to the insurance industry. That's just
financing for yokels. The yokels should finance for a shorter term.
Individuals looking for health insurance don't have an option.
Wes, this is a "free-market" deal. Republicans don't want to touch health
care costs by applying pressure to the insurance industry. But everyone
who's worked in the business knows that insurance companies are the ONLY
ONES who are in a position to apply pressure. If you won't pressure
insurers, your costs will keep spiraling up. That's because competition in
that industry is a myth. Thus, the "free market" is a myth. But don't tell
that to Republican legislators. They love their myths.
>
> Seriously, at a certain point, you loose sales. An insuance company makes
> nothing if a
> company drops their group coverage.
Insurance companies don't insure big companies. They collect fees. The
companies self-insure. Cost increases are the insured companies' problem.
And the increased income to insurance companies due to cost increases are
something like THREE TIMES what they could gain from increases in their
number of insured (they call them "lives," as in "we cover a million
lives"). Even significant losses in their numbers of insured don't outweigh
the annual cost increases that pump up their bottom lines.
> Due to how law is that people showing up at the e
> room must be treated and that cost is passed on to those that can pay,
> perhaps the
> insurance company looses money.
It comes out of taxes. Then we pay the insurance companies for our coverage.
Then costs increase, and we pay them more. Welcome to the money machine.
> My belief is while insurance companies like to make
> money, they also like to be able to find buyers for their product.
>
> Wes
They already have them. They'd love to have more, of course, if the
government will force us to buy insurance from them with no compensating
cost-cutting by the insurance companies. They want a deal like pharma got
with Medicare Part D. The necessary thing, soon, is to enforce a scheme for
reducing cost pressures. But the conservatives have extracted a "hands-off"
policy, for now, in exchange for their vote.
It really sucks. The insurance companies have us by the balls, either way it
goes.
--
Ed Huntress
>Wes, this is a "free-market" deal. Republicans don't want to touch health
>care costs by applying pressure to the insurance industry. But everyone
>who's worked in the business knows that insurance companies are the ONLY
>ONES who are in a position to apply pressure. If you won't pressure
>insurers, your costs will keep spiraling up. That's because competition in
>that industry is a myth. Thus, the "free market" is a myth. But don't tell
>that to Republican legislators. They love their myths.
Insurers pay bills submitted by medical providers. Why pick on the bill payer?
Look at who is submitting the bill and why it is so high.
Wes
Because they took it upon themselves to do so, decades ago, when they
started "managed care." Now they're the problem, because almost *all*
insurance is managed care; they've become an oligopoly; and they have little
or no incentive to reduce costs -- on their own.
It's like seatbelts in 1963. No manufacturer had an incentive to install
them as standard equipment. As the big three (or four) said to Congress at
that time, "if you don't force it, it's not going to happen."
Insurance companies have every reason to compete for the coverage they'll
provide. So they keep covering more procedures. But they have no incentive
to cut costs.
>
> Look at who is submitting the bill and why it is so high.
>
> Wes
It's high because the insurance companies will pay. There is no economic
reason for doctors or hospitals to cut their costs. None. That's why David
Brooks described it as a system of "perverse incentives."
Those are the realities of health care. That's why we need heavy-handed
health care reform, with plenty of regulation.
--
Ed Huntress
>
>"Wes" <clu...@lycos.com> wrote in message
>news:sjHdn.302190$H15....@en-nntp-02.dc1.easynews.com...
>> "Ed Huntress" <hunt...@optonline.net> wrote:
>>
>>>Wes, this is a "free-market" deal. Republicans don't want to touch health
>>>care costs by applying pressure to the insurance industry. But everyone
>>>who's worked in the business knows that insurance companies are the ONLY
>>>ONES who are in a position to apply pressure. If you won't pressure
>>>insurers, your costs will keep spiraling up. That's because competition in
>>>that industry is a myth. Thus, the "free market" is a myth. But don't tell
>>>that to Republican legislators. They love their myths.
>>
>>
>> Insurers pay bills submitted by medical providers. Why pick on the bill
>> payer?
>
>Because they took it upon themselves to do so, decades ago, when they
>started "managed care." Now they're the problem, because almost *all*
>insurance is managed care; they've become an oligopoly; and they have little
>or no incentive to reduce costs -- on their own.
Excuse me but "managed care" was their attempt to control costs.
>
>It's like seatbelts in 1963. No manufacturer had an incentive to install
>them as standard equipment. As the big three (or four) said to Congress at
>that time, "if you don't force it, it's not going to happen."
I don't see how this applies.
>
>Insurance companies have every reason to compete for the coverage they'll
>provide. So they keep covering more procedures. But they have no incentive
>to cut costs.
>
>>
>> Look at who is submitting the bill and why it is so high.
>>
>
>It's high because the insurance companies will pay. There is no economic
>reason for doctors or hospitals to cut their costs. None. That's why David
>Brooks described it as a system of "perverse incentives."
Just for a moment, let us consider grants and student loans, to help the less financially
fortunate attend college. Would you say that drives up the cost of a college education?
Yes, there will be a followup ;)
>
>Those are the realities of health care. That's why we need heavy-handed
>health care reform, with plenty of regulation.
Where does Medicare, Medicaid, CHIP and any other government run health insurance fit into
the escalation of medical costs? You seem to be focusing on only private health
insurance.
Wes
Excuse *me*, but managed care was an attempt to make more money. <g> When
the first company did it, it was an innovation. When more companies did it,
it was competition. When all companies do it, it's an oligopoly, in which
the tune is set by the handful of largest companies and all of the other
ones go along for the ride.
It's the difference between theory and reality. The reality is that the
business has evolved into one in which they compete superficially, at the
margins, while watching each other for changes in their coverage or
pricing -- which the others then match. That's how Ford, Chrysler, and GM
operated for years. It's how the oil companies operate. It's a classic way
of doing business where monopolies and cartels are not allowed.
>>
>>It's like seatbelts in 1963. No manufacturer had an incentive to install
>>them as standard equipment. As the big three (or four) said to Congress at
>>that time, "if you don't force it, it's not going to happen."
>
> I don't see how this applies.
You can get the insurance companies to operate in the public's interest. But
you have to break the back of their system of perverse incentives. This,
too, is classic business economics, which has to be applied where you have
market failure with big, perverse consequences.
The system of free-market capitalism works wherever you have real markets,
Wes. In health care, there are few real markets. Most of those markets are
broken in some way and don't allow one or another of the essential
components to work -- components like competition, free entry, perfect (or
at least good) consumer information and the option not to buy,
technologically-driven productivity increases, etc. The health care industry
is thoroughly buggered, in terms of free-market business models.
>
>>
>>Insurance companies have every reason to compete for the coverage they'll
>>provide. So they keep covering more procedures. But they have no incentive
>>to cut costs.
>>
>>>
>>> Look at who is submitting the bill and why it is so high.
>>>
>>
>>It's high because the insurance companies will pay. There is no economic
>>reason for doctors or hospitals to cut their costs. None. That's why David
>>Brooks described it as a system of "perverse incentives."
>
> Just for a moment, let us consider grants and student loans, to help the
> less financially
> fortunate attend college. Would you say that drives up the cost of a
> college education?
It may. The first effect, though, is to increase the market size. The larger
market probably drives costs *down*, because there are some economies of
scale involved. (Since health care is delivered on an individual basis, the
effect of scale is much different ) So college costs could be a wash, or
they could go slightly either way.
>
> Yes, there will be a followup ;)
>
>>
>>Those are the realities of health care. That's why we need heavy-handed
>>health care reform, with plenty of regulation.
>
> Where does Medicare, Medicaid, CHIP and any other government run health
> insurance fit into
> the escalation of medical costs? You seem to be focusing on only private
> health
> insurance.
Medicare pays less than private insurance. Medicaid pays less than Medicare.
Their effect is to slightly depress costs, relative to what private
insurance does.
--
Ed Huntress
True, but in another perverse twist, what this has lead to in unnecessary
procedures rather than reductions in per patient costs.
--
John R. Carroll
I'd have to see how that one works. It's true that doctors and hospitals
plump in some extra procedures to pump up their Medicare bills. But if the
entire system paid less, including private insurers, you'd be working with a
lower equilibrium cost for hospitals to remain viable. The system would have
to go through some fundamental changes or they couldn't be viable at all.
And private insurers, as I've said, have no incentive to put pressure on
costs. So the system doesn't change.
--
Ed Huntress
Go back and reread Gawande's New Yorker piece Ed.
Basically, the doctors have purchased the equipment necessary to do testing
themselves.
It encourages increased testing. The same is true with HMO's and PPO's.
They don't buy services from clinics affiliated with the hospitals which
means they keep more of the pie in house.
--
John R. Carroll
I don't have time to read something else about it now, John. But, having
worked in the industry for about five years, writing specifically to the
managed-care insurers (including Medicare and Medicaid), I can assure you
that there is very little push-back from *any* insurers except for things
that upset their actuarial projections -- QOL and EOL issues
(quality-of-life and end-of-life). Those are the wild cards, and insurers
don't take kindly to wild cards.
Sarah's "death panels" do exist. They're the Medical Directors and their
staffs in the private insurance companies. They're put in an impossible
ethical conflict between their medical oaths and their bonus programs. Some
of them swing one way, and some swing the other.
--
Ed Huntress
Well, you read it once and thought you might just remember.
--
John R. Carroll
Nah. My memory is starting to worry me, in fact. d8-)
--
Ed Huntress